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Chapter: 2400 Budgeting Income Program: MFAM 30 2430.0000 Family-Related Medicaid The sections below discuss income budgeting methodologies. 2430.0100 INCOME LIMITS (MFAM) Eligibility for Medicaid is determined by comparing the SFU’s countable income to the appropriate income standard. Refer to Appendix A-7 for the standard tables. 2430.0200 BUDGETING (MFAM) Budgeting processes determine how benefits will be calculated, by program, for the month. 2430.0201 Budget Period (MFAM) Eligibility is based on the standard filing unit composition, technical factors and income circumstances as they exist within the period for which benefits are being calculated. When budgeting for a future month, the estimated anticipated income and circumstances may be based on what occurred in prior months if those months are considered representative of the standard filing unit’s continued situation. Budgeting may also be based on the amount the individual can anticipate to receive. 2430.0204 Determining Monthly Income (MFAM) Several factors are involved in determining a gross amount of monthly income to be budgeted. These are anticipating and projecting income, averaging income, and converting the income to a monthly amount.

When income is received more often than monthly, it will be converted to a monthly amount. When averaging income, use the most recent consecutive four weeks or the best available information when it is representative of the individual's future income

Convert all pretax income exclusion amounts on the paystub/verification to a monthly amount (refer to Appendix A-37 for annual pretax income exclusion limits). 2430.0206 Budgeting Methods (MFAM) The process of computing the amount of income to be considered in determining financial eligibility and the coverage group(s) is called “budgeting”. When determining financial eligibility, one or more budget calculations will be completed. The best estimate of the standard filing unit’s income and circumstances is used to determine eligibility. When determining eligibility benefits for a past month, the SFU’s actual income and circumstances are used. The income is compared to the appropriate income limit to determine the coverage group. 2430.0500 INCOME AVERAGING (MFAM) Income averaging is a method used to adjust for fluctuations in income when the income is not verified through the Federal Data Services Hub (FDSH) or State Wage Information Collection Agency (SWICA) data, converted to a monthly amount.

When earned income is received more frequently than monthly, a four week average is used. When income is received semimonthly, the computation is averaged based on the most recent available one month of pay. When the income is received monthly, use the most recent one month pay, if representative.

When using an average, use only the weeks in the average that represent the ongoing pattern of employment. If there are significant breaks of one week or more without pay and the breaks are